Walders, whose naval career had begun 17 years earlier at a small naval hospital in Rota, Spain, was taking a big step. At age 36, he was about to take over IT at what is arguably the most important hospital in the military's medical system. But that system also had 14,000 unhappy users. The main source of IT problems was the recent merger of Walter Reed Hospital in Washington with the National Naval Medical Center in Bethesda, Md.

Walders, who believes in "business-driven IT," gathered user requirements and took action. He expanded the help desk from 64 to 110 people, implemented IT Infrastructure Library practices, increased training, upgraded support systems, and reduced wait time to minutes. He also made IT a 24/7 operation. Now, he says, the department is meeting its mission to better support the delivery of healthcare.

Lopez says Walders doesn't rattle easily, isn't standoffish and is "extremely engaged" with people. And now, he adds, the users like IT.